Treatment Under Fire

"The war taught us a lot about flexibility and adaptation to a changing reality. It was clear to us that we had to respond quickly and that our patients needed us now, perhaps more than ever."

On Saturday, October 7, 2023, Uzi Bitan, CEO of Meuhedet Health Fund, faced a challenging reality. As rockets rained down near his home in Lehavim, located in the south of Israel, and the security situation worsened, he immediately realized the need to move the health fund into emergency mode and respond quickly and efficiently and to provide essential medical services to patients, especially in the hardest-hit areas.

Uzi Bitan was born and raised in the Negev, the fourth of eight siblings. His life and sense of mission, instilled from childhood, connected him deeply to Israel's geographical and social peripheral regions. From a young age, he felt compelled to help these communities. "I believe everyone has a purpose in this world, and through that purpose, I have reached a place where I can strive to improve medical services in the periphery," he says.

Bitan's background and his military service as an Air Force officer shaped his approach to his role as a senior manager in the healthcare system. After completing a bachelor's degree in industrial and management engineering and a master's degree in business administration at Ben-Gurion University, Bitan began his career in healthcare in the 1990s, holding various management roles in Israeli health funds, including 14 years as the manager of the Southern District. "Before I was appointed CEO of Meuhedet, I served for 10 years as the health fund's Chief Operations Officer, so I know the system from all angles," he explains.

The attack on October 7 caught Bitan, like many others in southern Israel, off guard. "We heard the rockets flying overhead and thought we were entering yet another round of escalation," he recalls. Still, it quickly became clear that this was an unprecedented emergency situation, unlike anything we've been through before. It was clear to us that we had to respond quickly and that our patients needed us now, perhaps more than ever."

Bitan also ensured that Meuhedet's healthcare services were available in hotels housing evacuees from the South. "Our teams reached all the hotels, as far as Eilat and the Dead Sea," Bitan detailed, "and we reached out to all of our members, undersood their individual needs and either directed them to the nearest clinic or provided them with care on-site, including a mobile women's health unit and a mobile dental clinic that came to them." We also established a control center that managed the entire event, centralized the needs of the people, and proactively reached out to see how we could help," he shared.

Meuhedet also faced the challenge of maintaining continuous care in all clinics, even with rockets overhead and staff dealing with numerous challenges, including the closure of the education system. "On the morning of  October 8, we had opened all our clinics, in accordance with the Home Front Command's guidelines," Bitan said. "In Ashkelon, Netivot, and Be'er Sheva—when there was still concern about terrorists roaming the streets of Ashkelon—we made sure to take care of our patients and ensure they received the medical treatment they needed."Even after the dust began to settle, Bitan didn't waver from the emergency button, as the health fund, experienced with previous rounds of conflict, knew how to ensure that staff could arrive at clinics with peace of mind. "We set up about 50 daycare centers for the children of employees inside the health fund's clinics," he explained. This ensured that parents could continue providing essential medical services, knowing their children were in a safe environment.

The war also brought new challenges in the field of mental health. "This field was already suffering from a shortage of personnel before the war," Bitan explained, but in the new reality, with demand for mental health services skyrocketing, Meuhedet had to quickly expand services. Recognizing the need for accessible appointments, Meuhedet opened several new mental health clinics, expanded existing ones, and adjusted its treatment system to also offer remote therapy via phone calls. "We developed systems that provide up to 15 therapeutic phone sessions for people in immediate need of treatment," he explained, adding that despite these efforts, they still face significant challenges posed by the private market, where psychologists and psychiatrists can earn higher salaries than in the public health system.

Another major challenge Bitan highlighted is improving access to healthcare in the periphery. Having been born, raised, and still residing in the South, this issue is very close to his heart, and he admits that not a day goes by without him thinking about reducing healthcare disparities between the center and the periphery. For him, healthcare services must be available and accessible to everyone, everywhere in the country. One of the ways Meuhedet is working to reduce these gaps is through its mobile women's health unit, which travels to cities across the country, offering life-saving screenings like mammograms and ultrasounds to women, even in remote areas with limited access to these lifesaving examinations.

According to Bitan, this project is necessary due to low awareness and lack of access to important screening tests among women in distant areas. "We know that the percentage of women undergoing mammograms in the periphery is much lower than in the center. In the center, 80% of women get mammograms, compared to 60% or even 40% in the periphery," Bitan explains, emphasizing the importance of raising awareness to prevent breast cancer: "We want to increase awareness and ensure that women across the country, not just in the center, receive the screenings they need to prevent advanced-stage diseases. Imagine how many lives we can save."

Despite the war, Bitan implemented one of the projects he is most proud of this year—a network of urgent care centers that opened this year. "One of the biggest challenges in the healthcare system is the tremendous pressure on emergency rooms, especially in the evenings and on weekends, when health fund clinics are closed, and people need immediate medical attention," he explains.

This is where Meuhedet's urgent care centers come in. "We started operating a network of urgent care centers over the past year in Ashdod, Hadera, Tel Aviv, and soon in Rehovot, joining the one already successfully operating in Jerusalem." The urgent care centers operate in the evenings, on weekends, and during holidays, providing immediate professional care by specialist doctors, and patients are on their way within less than an hour after arriving. The urgent care center in Jerusalem, which operates continuously throughout the day, sees about 300 patients daily. The expert medical teams, many of whom also work in emergency rooms across the city, save lives daily, whether it's expertly removing a foreign body by a specialist doctor, diagnosing a heart attack, or quickly identifying a stroke.

"This year, we also decided to allow people to recieve flu vaccines at the urgent care centers. We understand that people are busy, working, and taking care of children, so it's convenient for them to take a few minutes for themselves in the evening. That's why we decided to provide the option of getting vaccinated at the urgent care centers in the evening, aiming to increase vaccination rates and save people from severe flu that could incapacitate them."

Meuhedet provides medical services to many populations, including new immigrants. Bitan describes the significant efforts invested in making information and services accessible in all languages, aiming to help new immigrants understand and navigate Israel's healthcare system, which can be confusing even for long-time residents, let alone for those who have just arrived.

In recent months, the health fund has invested extensive efforts in preparing for extreme scenarios in the north: "The health fund prepared a plan to care for ventilated patients in case of a blackout," Bitan shares. "In addition to generators, oxygen tanks, and readiness to evacuate patients to the center of the country if necessary, we have prepared ourselves for the most extreme scenarios, hoping they don't occur."

Bitan concludes the conversation with cautious optimism: "This war taught us a lot about flexibility, organization, and adapting to a changing reality. We learned that using technology and providing remote services, which we also did during the COVID-19 pandemic, along with proactive service, are essential tools we will take forward."

With a long-term strategy that includes opening additional urgent care centers, focusing on the periphery, and using new technologies, Meuhedet continues to work vigorously to provide the best care for its members, even in difficult times. "When the war ends, we'll come out stronger and more capable of providing even better medical service to our members," Bitan concludes.